Corneal collagen cross-linking (CXL) ALIREZA PEYMAN, MD ISFAHAN UNIVERSITY OF MEDICAL SCIENCES.

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Presentation transcript:

Corneal collagen cross-linking (CXL) ALIREZA PEYMAN, MD ISFAHAN UNIVERSITY OF MEDICAL SCIENCES

CXL with riboflavin and ultraviolet-A irradiation introduced in 1998 Spoerl E, Huhle M, Seiler T. Induction of cross-links in corneal tissue. Exp Eye Res. 1998;66:97–103.

Indications  Cornea ectasias  KC  PMD  Iatrogenic ectasias  Post-LASIK keratectasia  Infectious ulcers  Corneal edema

Importance of age of the patient  <10 years old    years     >40 

Technique  Using a wavelength of 370 nm with an accumulated irradiance of 5.4 J/cm 2 ensures that the exposure of all structures is below harmful levels

 Epi-Off  Epi-On Penetration of riboflavin Role of oxygen

Irradiation  Conventional  Accelerated  Pulsed

Complications  Significant haze  CTK  Infection

Combinations  CXL + ICRS  CXL + Microwave keratoplasty (Keraflex)  CXL + PRK  CXL + LASIK

Is repeat CXL helpful?